Case Study On Beta Blockers Induced Psoriasis

Drug-induced Psoriasis is one among the common etiological factors of Psoriasis reported worldwide. Familiar drugs known to cause psoriasiform eruptions include Anti-malarials, Beta blockers, NSAIDs, Lithium. etc. Certain antihypertensives like ACE inhibitors, diuretics are also documented to have caused psoriatic episodes. A 57 y old South-Indian male patient with a history of Hypertension, Diabetes Mellitus, Atrial Fibrillation for 4 y; was on antihypertensive therapy for Hypertension and Atrial Fibrillation with proponolol for past 2 y and metoprolol initially. He was presented to the hospital two weeks after switching on to Metoprolol therapy for chief complaints of erythematous scaly lesions especially over both the extremities and paronydrial appearance of nails. Initially, he was on Propranolol therapy which was then shifted to Metoprolol due to an appearance of oral lesions in the mouth. Metoprolol was now discontinued and switched on to Atenolol. After 1-2 w of therapy with Atenolol, the lesions were found to disappear and no recurrence of psoriatic conditions were found. Proper reviewing of medical history for any allergic reactions and the optimization of drug therapy through Therapeutic Drug Monitoring could be initiated by Clinical Pharmacist in order to avoid such drug-induced flares.

Antimalarial potential of Nosode 30 and 200 against Plasmodium berghei infection in BALB/c mice.

Background & objectives: Homeopathy is considered as an emerging area of alternative medicine which could be established for the global health care. One of the greatest objections to this science lies in its inability to explain the mechanism of action of the micro doses based on scientific experiments and proofs. The present study has been undertaken to screen in vivo antimalarial activity of Malaria Co Nosode 30 and Nosode 200 against Plasmodium berghei infection in BALB/c mice. Methods: Peter’s 4-day test was used to evaluate the in vivo schizontocidal effect of Nosode 30 and Nosode 200. One month follow-up study was done to calculate the mean survival time of mice in each group. Biochemical analysis was carried out to assess the liver and kidney function tests using diagnostic kits. Results: Nosode 30 and 200 exhibited 87.02 and 37.97% chemosuppression on Day 7 and mean survival time (MST) of 18.5 ± 2.16 and 16.5 ± 1.37 days respectively, which were extremely statistically significant when compared to MST of infected control (8.55 ± 0.83 days). The safety of Nosode 30 was also confirmed by the comparable levels of ALP, SGOT, SGPT activities, concentration of bilirubin, urea and creatinine to CQ treated group. Conclusion: Nosode 30 possesses considerable in vivo antiplasmodial activity against P. berghei infection as compared to Nosode 200 as evident from the chemosuppression obtained using Peter’s 4-day test. Further, studies on the drug can be carried out to establish its antimalarial potential in monotherapy or in combination with other homeopathic drug formulations.

Estimation of survival rates of breast cancer patients--a hospital-based study from Mumbai.

PURPOSE: To estimate the survival rates of breast cancer patients with reference to various factors like age, literacy status, residential status, T-stage and treatment. This is because there are very few studies reported from Indian subcontinent. METHODS: Survival rates were obtained by using the actuarial method and loss-adjusted survival rate method (LAR) for the above factors and the rates were compared. The present study carried out at the Tata Memorial Hospital (TMH), includes newly diagnosed (who were not treated elsewhere before attending TMH) primary breast cancer patients and having completed the initial treatment. RESULTS: The survival rates, actuarial survival and rates corrected for losses to follow-up (LAR) are presented. It showed that younger patients (<or=50 yrs) had a better 5-year survival ( 81%) than the older patients (> 50 years), with statistical significance ( p=0.024). There was no variation in survival with regard to the residential status but literate patients had a better ( non-significant) survival (77%) than their illiterate counterparts. T3-stage patients had the worst prognosis showing a 5-year survival of 60% (p=0.0002). Survival for those treated with surgery as the only modality and also in combination with other modalities did not show any remarkable differences except for the group that were treated with 'surgery in combination with chemotherapy'. The 5-year survival for those treated with surgery as the only modality was 83%. This study yielded useful information on breast cancer survival, especially in a situation with incomplete follow-up. The method applied (LAR) also clearly demonstrates the bias in estimates obtained by direct application of the standard actuarial method.

Retrospective study of severe cases of leptospirosis admitted in the intensive care unit.

OBJECTIVES: Evaluate patient demographics, risk factors, complications, seropositivity, treatment and outcome among leptospirosis patients. DESIGN: Retrospective analysis of 104 patients admitted in the intensive care unit (ICU) with a clinical suspicion of leptopirosis. SETTING: Ten-bedded medical ICU in a medical school situated in a rural area endemic for leptospirosis. MAIN OUTCOME MEASURES: Seropositivity for leptospirosis, patient demographics, risk factors, complications, treatment and survival. RESULTS: One hundred and four patients were admitted with a clinical suspicion of leptospirosis. Fifty-three (50.7%) were serologically confirmed cases. Males dominated both groups. Most of the admissions were in the monsoon season. Exposure to moist soil was the main risk factor. The mortality in the seronegative group was 26.8% while it was only 3.8% in the seropositive group. Multi-organ dysfunction syndrome, primarily acute respiratory distress syndrome with thromboctyopenia and renal failure were the causes for mortality. All the patients who died presented late into the illness. CONCLUSIONS: The initial diagnosis of leptospirosis depends on a high index of clinical suspicion, routinely available diagnostic tests being unreliable in the initial period. A reliable, unsophisticated test should be developed for early detection of this disease. As leptospirosis in its early stage mimics other tropical infections, both medical professionals and the general public (especially with risk of occupational exposure) should be educated about the disease and the need to seek early medical intervention.